Liver
Fibrosis in Women with Chronic Hepatitis C
By
Liz Highleyman Rates
of fibrosis progression in people with chronic hepatitis
C virus (HCV) infection differ significantly between men in women; in addition,
women tend to respond better to interferon-based
therapy. It has been suggested that an anti-fibrogenic effect of estrogen
may explain this finding, possibly because it inhibits the activity of hepatic
stellate cells that produce extracellular matrix, or fibrous tissue. As
reported in the September 26, 2006 online edition of Gut, Brazilian researchers
conducted a study to evaluate the severity of chronic hepatitis C in women, and
its association with menopause, steatosis
(fat accumulation in the liver), and hormone replacement therapy (HRT). Between
November 2003 and October 2004, 251 women with chronic hepatitis C were enrolled.
They completed a questionnaire and gave a blood sample on the day of liver
biopsy. Results
Out of the total of 251 women, 122 women (52%) were past menopause and 65 were
receiving HRT.
Compared to the 190 women (76%) with mild
fibrosis (F0-F1), the 61 women (24%) with moderate to severe fibrosis (Metavir
score F2-F4):
- had a longer known duration of HCV infection (greater than
15 years);
- had a higher body mass index (BMI);
- were more likely to
have steatosis.
Women with stage F2-F4 fibrosis were more often past menopause (67% vs 47%).
The probability of stage F2-F4 fibrosis was lower among post-menopausal women
using HRT (P = 0.012).
Steatosis was more frequent and more severe in post-menopausal women.
Conclusion In
conclusion, the authors wrote, "Severity of fibrosis was associated with
a longer duration of infection (> 15 years), a higher BMI, advanced steatosis
and menopause. [Post-menopausal] women [taking] HRT presented lower stage fibrosis." They
added that, "These results reinforce the hypothesis of a protective role
of estrogens in the progression of fibrosis. Steatosis may be implicated in the
progression of fibrosis after menopause." Hepatology
Unit, University of Bahia, Brazil. 10/17/06 Reference
L
Codes, T Asselah, D Cazals-Hatem, and others. Liver fibrosis in women with chronic
hepatitis C: evidence for the negative role of menopause and steatosis and the
potential benefit of hormone replacement therapy. Gut. September 27, 2006
[Epub ahead of print]. 
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